Living donor domino liver transplantation in a hepatitis C virus/human immunodeficiency virus-coinfected hemophilia patient: a case report

Hidekazu Yamamoto,Kaori Isono,Daiki Yoshii,Taizo Hibi,Yuzuru Sambommatsu,Taro Yamashita,Shuzo Matsushita,Yasuhiko Sugawara,Keita Shimata,Yukihiro Inomata,Masaki Honda

doi:10.1186/s40792-020-00944-4

Hidekazu Yamamoto, Kaori Isono + Show 9 more

Open Access

https://doi.org/10.1186/s40792-020-00944-4

Copy DOI

Abstract

BackgroundOutcome of the liver transplantation (LT) is worse in hepatitis C virus (HCV)/human immunodeficiency virus (HIV)-coinfected patients compared to patients infected with HCV alone. We report the world’s first case of living donor domino liver transplantation (LDDLT) using a familial amyloid polyneuropathy (FAP) liver in a coinfected recipient with HCV-related liver cirrhosis.Case presentationThe recipient was a 43-year-old male with a CD4 cell count of 52/μL and undetectable HIV-RNA at the time of LT. He received a domino liver graft from a 41-year-old female with FAP. No acute cellular rejection or infection occurred after LT. HCV recurrence was confirmed histologically on the posttransplant day 34. Peginterferon/ribavirin therapy resulted in non-response; however, the patient achieved a sustained viral response with sofosbuvir (SOF)/ledipasvir (LDV). Currently, HCV and HIV testing are negative, and symptomatic de novo amyloidosis has not occurred.ConclusionsLDDLT allows successful LT in HCV/HIV-coinfected patients; posttransplant HCV recurrence can be successfully treated with anti-viral therapy.

Highlights

Outcome of the liver transplantation (LT) is worse in hepatitis C virus (HCV)/human immunodeficiency virus (HIV)-coinfected patients compared to patients infected with HCV alone
living donor domino liver transplantation (LDDLT) allows successful LT in HCV/HIV-coinfected patients; posttransplant HCV recurrence can be successfully treated with anti-viral therapy
In the anti-retroviral therapy (ART) era, end-stage liver disease related to hepatitis C virus (HCV) and hepatitis B virus (HBV) coinfection has emerged as a main cause of morbidity and mortality in HIV-infected individuals; HCV- and HBV-related cirrhosis have

Summary

Conclusions

We report the world’s first case of LDDLT in a HCV/ HIV-coinfected who was a long survivor. DLT with a FAP liver can be a treatment option for liver cirrhosis associated with HCV/HIV-coinfection, de novo amyloidosis may later occur in the recipient. DAA therapy for recurrent HCV after LT is safe and effective in HCV/HIV-coinfected patients

Background

Findings

Discussion